Abstract:
Background: Despite the well-documented importance of change readiness to the successful implementation of complex change events, healthcare organisations regularly either fail to assimilate change events or fully realise expected benefits. This causes waste and increased costs at a time when many publicly funded health systems are facing significant service and financial constraints. Objective: This study seeks (a) to develop a practical, easily applied State of Readiness Tool (SoRT), which facilitates the introduction and assimilation of complex technology or processes into healthcare organisations; and (b) to identify contingency variables and appropriate response variables that influence change readiness positively. Participants: Key stakeholders included national policy makers in Government and the Ministry of Health and executive managers, local policy managers, operational managers, Needs Assessment and Service Coordination agency staff, geriatricians and other clinical staff in each of the six participating District Health Boards (DHB). Methods: In Phases One and Two, a qualitative, general inductive approach was employed using thematic analysis of raw data collected from semi-structured interviews and focus group in order to develop SoRT and to identify contingency variables influencing change readiness. In Phase Two, the utility of SoRT was reviewed through a stakeholder check using a focus group experienced in the implementation of change events into DHBs. Finally, in Phase Three, the diagnostic utility of the SoRT was assessed through its retrospective application to implementation processes used to introduce the interRAI-HC assessment tool at the six participating DHBs. Conclusion: A systematic, practical SoRT was developed based on a multi-stakeholder, multi-perspective process construct of change readiness. An expert focus group affirmed its construct validity and found the SoRT easy to use, useful and practical in assessing, enabling, re-assessing and continuously building change readiness, at all internal and external organisational levels, to implement planned change events successfully. The Study identified both contingency variables impacting change readiness and appropriate response variables. These provided both technical information useful in constructing the SoRT and insights valuable to the creation of change ready publicly funded health care organisations and employees in New Zealand.
